Kastl Justin T
Division of Pediatric Nephrology, University of South Dakota Sanford School of Medicine, Sanford Children's Hospital, 1600 W 22nd St., Sioux Falls, SD 57117, USA.
Semin Fetal Neonatal Med. 2017 Apr;22(2):83-89. doi: 10.1016/j.siny.2016.12.002. Epub 2017 Jan 18.
The use of serum creatinine levels to estimate glomerular function in infants is admittedly fraught with inherent inaccuracies which are both physiological and methodological in nature. This characteristic can understandably reduce the neonatal clinician's confidence in the ability of serum creatinine levels to provide useful information relevant to their patients' medical care. The aim of this review is to provide further insight into the peculiarities of serum creatinine trends in both premature and term infants with special focus on the maturational and developmental changes occurring in the kidney during this crucial time-period. Though newer markers of glomerular function are gaining increasing traction in the clinical realm, the most prominent of which is currently cystatin C, creatinine nonetheless remains an important player in the scientific evolution of glomerular filtration rate (GFR) estimation. Not only do its limitations provide a level of distinction for newer markers of GFR, but its advantages persist in refining the precision of newer GFR formulae which incorporate multiple patient characteristics.
诚然，使用血清肌酐水平来评估婴儿的肾小球功能存在固有的不准确之处，这些不准确既有生理方面的，也有方法学方面的。可以理解，这一特性会降低新生儿临床医生对血清肌酐水平能够提供与其患者医疗护理相关有用信息的信心。本综述的目的是进一步深入了解早产儿和足月儿血清肌酐变化趋势的特点，特别关注这一关键时期肾脏发生的成熟和发育变化。尽管肾小球功能的新标志物在临床领域越来越受到关注，目前最突出的是胱抑素C，但肌酐在肾小球滤过率（GFR）估计的科学发展中仍然是一个重要因素。其局限性不仅为GFR的新标志物提供了一定的区分度，而且其优势在于提高了纳入多种患者特征的新GFR公式的精度。
